JASON CHRISTOPHER CLARK M.D. NPI 1104951086

NPI Information

NPI: 1104951086
Provider Name: JASON CHRISTOPHER CLARK, M.D.
Classification: General Practice - 208D00000X
Entity Type: Individual
Address:
9040 REID ST
MADIGAN ARMY MEDICAL CENTER, ATTN MCHJ-EDME
TACOMA, WA
ZIP 98431
Phone: (253) 968-0354
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Jason Christopher Clark, M.D. is a general practice in Tacoma, WA. Jason Christopher Clark, M.D. NPI is 1104951086. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

9040 REID ST
MADIGAN ARMY MEDICAL CENTER, ATTN MCHJ-EDME
TACOMA, WA
ZIP 98431-100
Phone: (253) 968-0354
Fax: (253) 968-5926

The enumeration date for this NPI number is 2/22/2007 and was last updated on 7/8/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	208D00000X	General Practice		24024	NEBRASKA	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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